title: Hepatocellular carcinoma: clinical study of long-term survival and choice of treatment modalities.
abstract: OBJECTIVE
  To analyze the prognostic factors of 5-year survival and 10-year survival in hepatocellular carcinoma (HCC) patients, and to explore the reasons for long-term survival and provide choice of treatment modalities for HCC patients.
  
  
  METHODS
  From January 1990 to October 2012, 8450 HCC patients were included in a prospective database compiled by the Information Center after hospital admission. Long-term surviving patients were included in a 10-year survival group (520 patients) and a 5-year survival group (1516 patients) for analysis.The long-term survival of HCC patients was defined as the survival of 5 years or longer. Clinical and biologic variables were assessed using univariate and multivariate analyses. The survival of patients was evaluated by follow-up data.
  
  
  RESULTS
  The long-term survival of HCC patients was associated with the number of lesions, liver cirrhosis and Child-Pugh classification. It was not found to be associated with tumor diameter, histological stage, and pretreatment level of serum α-fetoprotein. The differences in clinical factors between the 5-year survival and the 10-year survival were found to be the number of lesions, liver cirrhosis, Child-Pugh classification, and time elapsed until first recurrence or metastasis. The survival period of different treatment modalities in the patients who survived for 5 years and 10 years showed significant differences: (in order of significance) surgery alone > surgery-transcatheter arterial chemoembolization (TACE) > TACE-radiofrequency ablation (RFA) > TACE alone > surgery-TACE-RFA. The 10-year survival of HCC patients was not associated with the choice of treatment modality.
  
  
  CONCLUSIONS
  This retrospective study elucidated survival outcomes, prognostic factors affecting survival and treatment modalities in HCC patients.
authors.affiliation: Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
authors.forename: Ke-Tong
authors.initials: KT
authors.lastname: Wu
authors.forename: Cun-Chuan
authors.initials: CC
authors.lastname: Wang
authors.forename: Li-Gong
authors.initials: LG
authors.lastname: Lu
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Zhang
authors.forename: Fu-Jun
authors.initials: FJ
authors.lastname: Zhang
authors.forename: Feng
authors.initials: F
authors.lastname: Shi
authors.forename: Chuan-Xing
authors.initials: CX
authors.lastname: Li
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Clinical study; Hepatocellular carcinoma; Radiofrequency ablation; Statistical analysis; Surgery; Transcatheter arterial chemoembolization